Individual provider Active NPI

Reza Mohammad Safarpour, RPH

  • Pharmacist
  • Salt Lake City, UT
National Provider Identifier
1942278395
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
2797369-1701 Issued in UT
Practice address
4111 Jupiter Dr
Salt Lake City, UT 84124-3341
Phone
(801) 272-0550
NPI assigned
Mar 10, 2006
Last updated
Dec 13, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 2797369-1701 UT Primary
Pharmacist 183500000X PH00022047 WA

Addresses

Primary practice location

4111 Jupiter Dr
Salt Lake City, UT 84124-3341

Mailing address

4111 Jupiter Dr
Salt Lake City, UT 84124-3341
Phone (801) 272-0550

Other identifiers 2

IdentifierTypeStateIssuer
2797369OtherUTSTATE LICENSE NUMBER
PH00022047OtherWASTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
2797369-1701UTMDPharmacist
PH00022047WAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1942278395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 JUPITER DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841243341",
            "telephone_number": "801-272-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 JUPITER DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841243341",
            "telephone_number": "801-272-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFARPOUR",
        "first_name": "REZA",
        "middle_name": "MOHAMMAD",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "2797369-1701",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00022047",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "2797369",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "PH00022047",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.